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Women’s Health

New Non-Hormonal Birth Control: What to know

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Non-hormonal birth control can be an effective way to prevent pregnancy for people who have certain health conditions or who want to avoid the side effects of hormonal birth control.

The options for non-hormonal birth control consisted of barrier methods (like condoms and cervical caps), spermicides, copper intrauterine devices (IUDs), and sterilization, until recently a new option called Phhexxi hit the market.

The Food & Drug Administration (FDA) approved the vaginal gel on May 22, 2020, thereby expanding the range of non-hormonal contraceptives.

“Before Phexxi was approved, there had been no major innovations in non-hormonal birth control for over 30 years,” said Dr. Charis Chambers, gynecologist.

Read on to learn more about the new non-hormonal birth control gel, including:

  • possible side effects
  • how well it works
  • where to find it
  • how to decide if it’s right for you

Phexxi is a new non-hormonal contraceptive gel available by prescription that is inserted into the vagina just before penis-in-vagina sex to reduce the risk of pregnancy. It works by preventing the sperm from changing the pH of the vagina.

A vagina is usually acidic, with a pH around 4, according to the National Women’s Health Network (NWHN). As sperm enters the vagina, the pH typically rises to a neutral or slightly basic level of 7 or 8, which creates a more protective environment for the sperm.

The gel keeps the vagina’s pH in the more acidic range, which makes it inhospitable to sperm.

In other words, “It paralyzes the sperm so it can’t survive and make someone pregnant,” explained Dr. Tamika Cross, certified gynecologist.

What is it made of?

Phexxi consists of three active ingredients:

  • Lactic acid, found in dairy products and naturally produced by the vagina
  • Citric acid, a compound found in citrus fruits
  • Potassium bitartrate, a by-product of winemaking also known as tartar (a baking ingredient)

These three ingredients work together to maintain the acidic pH of your vagina in the presence of semen.

Who should use it?

The contraceptive gel can be used by many people with a vagina who want to prevent pregnancy without hormones.

“Phexxi is good for people who are unable to use hormonal birth control because of a specific condition – be it a history of cancer or blood clots,” said Cross.

It can be a good choice if you are looking for a non-hormonal birth control option that:

  • does not have to be taken every day
  • is easy to start and stop
  • will not affect your long-term fertility
  • can be used discreetly without your partner’s involvement
  • can be used at the moment and at any time during your menstrual cycle
  • is safe to use several times a day
  • can be used with some (but not all) other contraceptives

You can use the contraceptive gel as soon as your doctor approves you for penis-in-vagina sex after giving birth, miscarriage, or an abortion after the NWHN.

However, Planned Parenthood suggests that there are a few reasons you might want to avoid Phexxi, including:

  • You are using the vaginal ring
  • you are pregnant (or do you think you might be)
  • You have a history of urinary tract infections (UTIs) or other urinary tract problems
  • You (or your partner) are sensitive or allergic to the active ingredients in the gel

It’s also important to note that Phexxi doesn’t prevent sexually transmitted infections (STIs). You may need to combine it with another type of birth control, such as birth control. B. a barrier method to reduce your risk of STIs.

Phexxi is used in a similar way to some spermicides by inserting it into the vagina before penis-in-vagina sex.

The gel is supplied in pre-filled, individually wrapped applicators. To use it, you need to unpack the packaging, slide the plunger rod into the applicator, and remove the pink cap.

Then push the applicator into the vagina as far as possible, holding onto the grooved area. Finally, use your index finger to press the rod that will introduce the gel into the vagina and remove the applicator.

For Phexxi to be most effective, it should not be used in the vagina more than 1 hour before sex with the penis. You’ll also need to use a different gel applicator if you’re planning on another round.

“One Phexxi dispenser is the same as one ejaculate,” said Cross.

When used as directed by a doctor, Phexxi is 93 percent effective, according to the company. But with typical use (meaning it may not be perfect), its effectiveness drops to 86 percent.

That means that about 14 out of 100 people using Phexxi as their only method of contraception may not work.

According to the FDA, non-hormonal contraceptive gel is more effective than a male, female condom or spermicide. However, it is less effective in preventing pregnancy than oral contraception, the patch, syringes, IUDs, or surgical sterilization.

However, using Phexxi with some other birth control may make the gel more effective. Although it cannot be used with vaginal rings, it can be used with:

  • Condoms
  • cervical caps
  • Membranes
  • birth control pills
  • the contraceptive patch

You’ll need to use a different type of birth control to prevent STIs.

While Phexxi doesn’t have the same side effects as hormonal contraceptives, it does come with certain risks.

The most common side effects of the non-hormonal contraceptive gel include:

  • vaginal burning, itching, or vaginal discomfort
  • Yeast infections
  • Urinary tract infections
  • bacterial vaginosis (a type of infection of the vagina caused by bacteria)
  • vaginal discharge

In clinical studies with the gel, a few cases of bladder and kidney infections have been reported, one of which was serious.

Other than that, side effects are rare and when they do occur they tend to be mild. According to the manufacturer, less than 2 percent of clinical trial participants stopped using Phexxi due to a side effect.

Unlike some other contraceptives, Phexxi can cause side effects in your sexual partner as well. Some men have had genital discomfort after having sex with the penis in the vagina with someone who used the gel.

You should not use Phexxi if you or your partner are allergic to any of the ingredients in the contraceptive, including:

  • Lactic acid
  • citric acid
  • Potassium bitartrate

Phexxi sells in boxes of 12 pre-filled applicators for a total of $ 267.50, but the actual price you pay at the pharmacy can be significantly lower depending on your circumstances.

If your health insurance company takes over the contraceptive gel, you may be able to get it cheaper or pay nothing at all. Those who are uninsured may be able to get them for free or at low cost through their local planned parenting health center.

Phexxi also offers a savings program that offers a $ 0 copay for a person’s first box and prices as low as $ 30 for the refill. However, only certain people are eligible to participate. The program is not available to people using certain government programs, such as Medicare and Medicaid, to cover some or all of their prescription drugs.

While Phexxi is the newest FDA-cleared non-hormonal birth control option, other options are also in the works.

There is a new copper spiral – the IUB Ballerine – which was developed in Israel. Like the copper IUD, the IUB Ballerine is hormone-free, but has a round shape. It is inserted into the uterus by a doctor to prevent pregnancy for up to 5 years. The company reports that this birth control is 99 percent effective.

While the IUB Ballerine is used in 30 countries, it is not yet approved in the United States.

Meanwhile, another startup, Cirqle Biomedical, is working on a new type of non-hormonal birth control called Oui. It’s a capsule that quickly dissolves in the vagina to make the cervical mucus impervious to sperm.

Although the product has shown positive results in animal studies, Forbes says it still has to prove its safety and effectiveness in human clinical trials before it becomes available.

Talk to your doctor to learn about new types of birth control that are available to you.

The FDA approved a new contraceptive gel called Phexxi in May 2020, which expands the non-hormonal contraception options available.

It works by lowering the pH in the vagina to make it harder for sperm to enter an egg. You can use a pre-filled applicator to insert the gel into the vagina up to an hour before penis-in-vagina sex.

Side effects are relatively rare, but if you have a history of urinary tract infections or bladder problems you may want to try another method of birth control.

Talk to your doctor about the risks and benefits of Phexxi to see if a prescription for the birth control gel is right for you.

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Women’s Health

How To Use Your Phone To Stay Happy And Healthy

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The NHS has promised a digital revolution to transform patient care. The wider use of technology is at the heart of a ten-year plan to reduce disease by developing digital tools that help the public better manage disease.

However, a study published yesterday by the Organization for the Review of Care and Health Apps evaluating digital health tools like smartphone apps for healthcare found that older people often miss out on the benefits of technology.

Good Health looks at just a few of the smartphone apps that could improve the health of the elderly

It found that GPs recommend NHS-approved apps to more than twice as many people under 35 as people over 55 – although the majority of older people said they’d love to try NHS-approved health apps.

Patient Safety Learning, a charity that works for improved standards in health care, said doctors fail to educate older people about the wide range of NHS-supported health apps that could benefit their wellbeing.

Good Health looks at just a few of the smartphone apps that could improve the health of the elderly, while Dr. Trisha Macnair, an elderly care specialist from Phyllis Tuckwell Hospice in Farnham, Surrey, delivers her verdict. . .

Reminders for Coping with Dementia

My House Of Memories, free on Google Play on Android devices or AppStore on Apple devices

Dementia, which affects around 800,000 mostly elderly people in the UK, not only robs people of their memories, but often causes restlessness. My House Of Memories would like to help by saving images or sounds from the past that those affected find comforting.

This could simply be a picture of old currency from her childhood – like a ten shilling note – or a Singer sewing machine that brings back fond memories of a relative who made clothes for her.

Personalized pictures – such as pictures of favorite objects, loved ones or old school friends – can also be uploaded to the app.

Expert judgment: “From caring for people with dementia, we know that remembering beautiful and distant memories can help them deal with their illness. It allows them to feel engaged, which improves their mood and quality of life. So I’m sure this could be beneficial – although it will take a caregiver’s help to use it. ‘

How to Use Your Phone to Stay Happy and Healthy

Medicine sent to your door

Hey pharmacist, it’s free on Google Play or the AppStore

According to charity Age UK, around four million people over 65 in the UK take five or more prescription drugs – many of them every day.

For elderly patients, ensuring uninterrupted supply of these drugs is essential, even when many are home-bound.

The NHS-approved Hey Pharmacist app is designed to relieve headaches by allowing patients to order repeat prescriptions through the app at any pharmacy in England and have them delivered to their door.

After downloading the app and sending a prescription request, it is checked by the patient’s family doctor and delivered within a few days. The app can remind the patient to order another prescription when supplies are running low.

Expert judgment: “This is really useful. I work in elderly care and I’m constantly trying to convince patients to use his type of technology to make sure they don’t run out of medication.

“Those who are familiar with smartphone apps seem pretty easy to understand – but it can be more difficult for those in their late 70s.”

How to Use Your Phone to Stay Happy and Healthy

Take a home stress test

EXi, free of charge on Google Play or AppStore

General practitioners who want to assess an older person’s fitness often refer them to a six-minute walk test – how far they can go in that time. It is a measure of aerobic fitness and a crucial guide to overall wellbeing.

The EXi app enables patients to take the test in their own garden or while taking a walk on site instead of having to go to a clinic.

It also creates a 12-week exercise plan based on each patient’s own health information – such as weight, underlying health issues, and whether or not they smoke. The app gradually increases the level of training until the patient complies with the NHS recommended five 30-minute sessions per week at the end of three months of treatment.

Expert judgment: “This could be useful, but we know that most people find it difficult to motivate themselves to exercise unless there is someone around to do it. This is especially true for older people, for whom social interaction is just as important as physical exercise. “

How to Use Your Phone to Stay Happy and Healthy

App to deal with leaks

Squeezy, £ 2.99, Google Play or AppStore

AN estimates that seven million people in the UK – mostly women – have urinary incontinence. It tends to affect the elderly because the muscles that control bladder function get weaker with age.

Pelvic floor exercises are known to help fight the problem, but must be done regularly and properly to get any real benefit – something many patients struggle with. The Squeezy app is aimed at both men and women and offers patients a pelvic floor exercise plan developed by physiotherapists who specialize in women’s health.

Users are given clear instructions on how to perform pelvic floor exercises effectively – to improve bladder control – and a journal feature allows them to record improvements in their condition.

Expert judgment: “A really helpful app. Half the problem with pelvic floor exercises is that you’re never quite sure you’re tensing the right muscles, but with this app to guide you, the chances are much less. ‘

How to Use Your Phone to Stay Happy and Healthy

Manage your heart health

Activate the self-care app, free of charge on Google Play or in the AppStore

At least one million people in the UK have atrial fibrillation, which is when an abnormal heartbeat causes blood to build up in the heart’s pumping chambers – which increases the risk of a clot that could cause a stroke.

The average age of onset is around 75 years. Many of the diagnosed patients rely on the blood-thinning drug warfarin to reduce their risk of stroke. However, the drug must be carefully monitored as too much can lead to life-threatening internal bleeding.

This means having regular tests at a clinic – usually every four to six weeks – to measure the amount of the drug in the blood.

The NHS-approved Engage app allows patients to do this at home – without hospitalization – provided they have received a test kit from their GP.

The app saves readings and wirelessly shares them with the patient’s doctor so that he can remotely monitor drug levels.

Expert Verdict: “Most patients who take warfarin either need regular checkups or a county nurse calls every few weeks to get a blood sample, but the app could make life a lot easier.”

Keep track of daily pills

How to Use Your Phone to Stay Happy and Healthy

Pillboxie, £ 1.79, AppStore

Billed as an “easy way to remember your medication”, you can use this app to record every day which tablets you have to take and at what time. But what makes this so user-friendly is that there are visual – and not just text-based – reminders of taking medication.

For example, if a medication has to be taken at 7 a.m., a tablet appears in the picture of a pill box and remains there until the patient informs the app that they have taken the medication. Separately, the app can flash a list of ‘medication due today’ that the patient can tick off on the go.

Expert verdict: “Apps like this are a great idea and the visual element will likely make them more user-friendly. I know pharmacists sometimes have to call patients every day to remind them to take their medication. Using this app could prevent patients from accidentally missing doses. “

Sounds like nodding off

How to Use Your Phone to Stay Happy and Healthy

Pzizz, for free on Google Play or AppStore

Many older people have trouble sleeping. This may be due to a day nap, which reduces nighttime fatigue. The Pzizz app uses a complex mix of music, voice overs, and various background sound effects to create a “dream landscape” described by the creators as a “dream landscape” that promotes sleep.

Expert judgment: “Sleep problems are very common in older people and they can become afraid of them, which can make falling asleep even more difficult. This app could possibly help. ‘

Stay mobile to relieve pain

How to Use Your Phone to Stay Happy and Healthy

ESCAPE-Pain-App, free of charge on Google Play

In the case of chronic pain, it is important to stay mobile. The Escape Pain app is for people with pain who want to stay mobile at home instead of attending fitness classes. It includes videos with clear instructions on gentle exercise and allows users to track their progress and track pain.

Expert verdict: “We know that in diseases like osteoarthritis, which affects around eight million people in the UK, staying mobile is essential to control pain and maintain muscle strength.

“Apps like this can help patients find the right type and amount of exercise for them.”

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Women’s Health

Scientists Have Discovered A Surprising Relationship Between Estrogen and Exercise

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In recent years, the influence of hormones on exercise has become a major topic of conversation affecting sports, exercise, and especially female athletes. Ignoring hormones when it comes to female athletes and training means ignoring vital opportunities for increased intensity and rest as the body adapts to hormone production. In a 2016 pool interview, Olympic bronze medal swimmer Fu Yuanhui talked about how her period affected her performance at the Olympics, which was seldom talked about in women’s sport of this level. Now women athletes speak publicly about the effects of the menstrual cycle on performance, with scientific studies further showing how hormones can lead to different training outcomes.

Since a 1924 study in rats, scientists have known that female mammals are most physically active just before ovulation, which also coincides with the time they are sexually receptive. Researchers have since speculated that such a shift was due to estrogen, which acts as a driving factor in this behavior.

For Holly Ingraham, the Herzstein Endowed Professor of Physiology at the University of California, she wanted to investigate how estrogen affects genetic activity in the brain and what this means for exercise. Studies were conducted in healthy adult female mice, with some chemically blocking estrogen uptake while the researchers tracked how much all animals moved. It was immediately clear that those without estrogen became noticeably more sedentary than other women, suggesting that estrogen somehow affects physical activity.

The study suggests that the timing of exercise for women could be fine-tuned to account for hormonal changes. While the study needs to be confirmed in humans, the researchers have strong reason to believe that such results will be seen in women, which may help explain why inactivity is so common in postmenopausal women. As the New York Times suggests, “Raising estrogen levels in older women, for example, could theoretically encourage more exercise, although estrogen replacement therapy remains a complicated topic due to the increased risk of cancer and other health concerns.”

Paul Ansdel, Lecturer in Exercise Physiology at Northumbria University in England, who was not involved in the study but did a lot of research on menstruation and physical performance: “This study has a significant impact on human research, the menstrual cycle and hormonal contraceptives as well Investigates menopause. ”Ansdel added,“ We ​​know how important exercise is for promoting and maintaining good health in later life, ”adding,“ The challenge for us now is to understand the best ways to exercise during major hormonal change, menopause to stay active. ”

Dr. Ingraham hopes this research can now be used to better understand how we move and why, with the intent of making our older years healthier. With regard to training and one’s own cycle, several studies have shown that strength training in the follicular phase resulted in greater muscle strength gains compared to training in the luteal phase, while women are 3 to 6 times more likely to be injured by their ACL than men, with the Risk is highest in the days leading up to ovulation, when estrogen is high. Ultimately, keeping an eye on your cycle is important and can do wonders for your athletic performance, but understanding it is even more important. It is important not to judge the results of your training by your performance, as in some cases hormones play an important role.

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Women’s Health

FIGO 2021 World Congress Blog – Day Four

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Live from the Israel Forum: Urogynecology

The fourth day of the congress opened with a session on urogynecology, which was broadcast live from the Israel Forum of the FIGO 2021 World Congress. Dr. Shimon Ginath opened the session and prepared the framework for the discussion on the tailor-made optimal treatment of the prolapse of the apical compartment. Dr. Tal Fligelman took the stage first to explain vaginal procedures in surgery, followed by Dr. Jonia Alshiek, who checked the abdominal approach. The session ended with a short but very exciting panel discussion.

Keynote: Urgent need for trauma-sensitive care

This was followed by a keynote lecture by Dr. Monika Hauser on the subject of solidarity, empowerment, dignity – trauma-sensitive support for women and girls (not only) in war and crisis areas. “When treating women’s health issues, not only the medical or psychological aspects have to be taken into account, but also the societal and political context,” began Dr. Hauser gave her lecture. Her presentation focused on the need for trauma-sensitive support and care for survivors of violence and highlighted the need for stakeholders at all levels of policy-making and health care to play a role in supporting their rights and needs.

The role of health workers in responding to the climate crisis

We continued the day with a session called Putting Out the Fire! – Dealing with the risks of extreme heat to maternal and newborn health due to climate change. This session was initiated by Professor Sari Kovats who discussed the effects of extreme heat on maternal and newborn outcomes in Africa, focusing mainly on direct effects based on epidemiology. Dr. Seni Kouanda followed up with a lecture that examined how heat stress is experienced during pregnancy and after childbirth, and presented possible ways to address it.

Professor Matthew Chersich followed up with a presentation with practical advice on how clinical care can be adjusted to protect women and newborns during heat waves. Frances McConville presented key findings from the Lancet Planetary Health survey, Views of Health Professionals on Climate Change and Health: A Multinational Study, Focusing on Climate Change as a Human Health Issue.

The session ended with an exciting panel discussion with Dr. Diarmid Campbell-Lendrum, Team Leader for Climate Change and Health at the World Health Organization (WHO), Dr. Franka Cadée, President of the International Midwifery Association and Dr. Jeanne Conry, FIGO President – elections. The conversation focused on the next steps and pathways for professional organizations that support health professionals in advocating for responses to climate change.

ART in resource-poor countries

Later, the FIGO Reproductive Medicine Track organized a session on assisted reproductive technology (ART) in resource-poor countries. Dr. Geeta Nargund started with a talk on natural and mild in vitro fertilization (IVF). She highlighted that these methods are not only effective, but also cheaper and provide better health outcomes for women. Dr. Roberto Epifanio Malpassi examined the inexpensive ART and examined in particular the trends of (in) fertility in the Latin American region in recent years.

Dr. In her presentation, Angélique Rwiyereka focused on a case study that detailed the institutionalization of infertility services in a public hospital in Rwanda and shared lessons from the success of the initiative. Dr. Gitau Mburu closed the session with an update on current WHO initiatives related to infertility.

COVID-19 and cancer

The day continued with a series of sessions including insightful presentations on COVID and cancer in a session compiled by the FIGO Gynecological Oncology Track. Professor Sean Kehoe opened the session with a talk on the impact of COVID-19 on cancer screening and care for women with gynecological cancers – with a special focus on cervical cancer.

Dr. Jalid Sehouli spoke about the impact of the pandemic on ovarian cancer and chemotherapy and underlined the challenges for patients, doctors and nurses. Dr. John Butler ended the session by making post-pandemic recommendations and reviewing clinical trials and surgical technique changes to identify key lessons learned from this crisis for cancer care.

Addressing the health challenges of women and girls in Africa and the Middle East

We ended the day with the Africa and Middle East regional evening, which was jointly organized by the African Federation for Obstetrics and Gynecology (AFOG) and the Société Africaine des Gynécologues et Obstétriciens (SAGO). With a focus on social engagement, HIV, maternal mortality, HPV, FGM and more, this evening covered a wide range of topics that affect the health of women and girls in the region. That evening included politically engaged musical numbers that highlighted key issues such as songs about cervical cancer and FGM.

It was an exciting and moving end to this world congress day. Recordings of the entire meeting will be available on demand on the virtual congress platform within 24 hours.

To learn more about the congress or to register, visit www.figo2021.org.

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